Amateur soccer is responsible for a surprisingly high number of fractures and other significant injuries to the mouth, jaw, and face, reports a study in the September issue of The Journal of Craniofacial Surgery.

Increased use of mouthguards and faceguards could help to prevent many soccer-related oral and craniofacial injuries, but efforts are needed to increase the use of this protective equipment, concludes the study by Drs. Sinan and Ummuhan Tozoglu of Ataturk University, Erzurum, Turkey.

The researchers reviewed all patients with injuries to the mouth, jaw, and face area seen at their oral surgery department over a one-year period. Eleven of the 53 injuries were related to amateur soccer - a rate of over 20 percent. Most of the injuries occurred in young men, aged 18 to 24.

Dental fractures were the most common type of soccer-related injury, followed closely by fractures of the lower jaw (mandible) and problems with the temporomandibular joint (TMJ - the joint that moves the jaws). One soccer player had a broken nose. About two-thirds of the injuries occurred when one player ran into another. The rest were caused by impact with equipment or the ground.

Head injuries are common in sports - up to ten percent of all head injuries may be sports-related. Certain sports have been identified as carrying a high risk of severe head injuries, such as football, gymnastics, ice hockey, and wrestling. In contrast, soccer has not generally been regarded as a high-risk sport for head and facial injuries.

In the authors’ experience - at an oral surgery department in a country where soccer is enormously popular - one in five serious oral and craniofacial injuries is soccer related. The true rate is probably even higher, as soccer players with injuries to the eye and nose area would likely be seen by other specialists.

Wearing mouthguards and faceguards could prevent many of these injuries, Drs. Tozoglu and Tozoglu point out. These devices protect against direct injury to the mouth, teeth, jaws, and nose, while also reducing the risk of concussions and other potentially serious injuries. However, rates of mouthguard use by soccer players are very low, partly because of problems with fit and comfort. The authors call for better enforcement by coaches and officials to increase the use of mouthguards in amateur soccer. They also urge improvements in equipment to make these devices more comfortable for routine use.